|
HC ARWY MASK LMA UNIQUE SIZE 1
|
Facility
|
IP
|
$47.56
|
|
| Hospital Charge Code |
901698403
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
|
|
HC ARWY MASK LMA UNIQUE SIZE 1
|
Facility
|
OP
|
$47.56
|
|
| Hospital Charge Code |
901698403
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.67
|
| Rate for Payer: Blue Shield of California Commercial |
$30.15
|
| Rate for Payer: Blue Shield of California EPN |
$18.98
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: Cigna of CA HMO |
$30.44
|
| Rate for Payer: Cigna of CA PPO |
$35.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33.29
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
| Rate for Payer: Riverside University Health System MISP |
$19.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.78
|
| Rate for Payer: United Healthcare All Other HMO |
$23.78
|
| Rate for Payer: United Healthcare HMO Rider |
$23.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.43
|
| Rate for Payer: Vantage Medical Group Senior |
$40.43
|
|
|
HC ARWY NASAL 12FR THIN WALL STERILE
|
Facility
|
OP
|
$15.17
|
|
| Hospital Charge Code |
901606460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$13.65 |
| Rate for Payer: Adventist Health Commercial |
$3.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.82
|
| Rate for Payer: Blue Shield of California Commercial |
$9.62
|
| Rate for Payer: Blue Shield of California EPN |
$6.05
|
| Rate for Payer: Cash Price |
$6.83
|
| Rate for Payer: Central Health Plan Commercial |
$12.14
|
| Rate for Payer: Cigna of CA HMO |
$9.71
|
| Rate for Payer: Cigna of CA PPO |
$11.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.07
|
| Rate for Payer: EPIC Health Plan Senior |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$12.89
|
| Rate for Payer: Global Benefits Group Commercial |
$9.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.62
|
| Rate for Payer: Multiplan Commercial |
$11.38
|
| Rate for Payer: Networks By Design Commercial |
$9.86
|
| Rate for Payer: Prime Health Services Commercial |
$12.89
|
| Rate for Payer: Riverside University Health System MISP |
$6.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.58
|
| Rate for Payer: United Healthcare All Other HMO |
$7.58
|
| Rate for Payer: United Healthcare HMO Rider |
$7.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.89
|
| Rate for Payer: Vantage Medical Group Senior |
$12.89
|
|
|
HC ARWY NASAL 12FR THIN WALL STERILE
|
Facility
|
IP
|
$15.17
|
|
| Hospital Charge Code |
901606460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$13.65 |
| Rate for Payer: Adventist Health Commercial |
$3.03
|
| Rate for Payer: Cash Price |
$6.83
|
| Rate for Payer: Central Health Plan Commercial |
$12.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.07
|
| Rate for Payer: EPIC Health Plan Senior |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$12.89
|
| Rate for Payer: Global Benefits Group Commercial |
$9.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.03
|
| Rate for Payer: Multiplan Commercial |
$11.38
|
| Rate for Payer: Networks By Design Commercial |
$9.86
|
| Rate for Payer: Prime Health Services Commercial |
$12.89
|
|
|
HC ARWY NASAL 14FR THIN WALL STERILE
|
Facility
|
OP
|
$15.33
|
|
| Hospital Charge Code |
901606461
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.92
|
| Rate for Payer: Blue Shield of California Commercial |
$9.72
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: Cigna of CA HMO |
$9.81
|
| Rate for Payer: Cigna of CA PPO |
$11.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
| Rate for Payer: Riverside University Health System MISP |
$6.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.67
|
| Rate for Payer: United Healthcare All Other HMO |
$7.67
|
| Rate for Payer: United Healthcare HMO Rider |
$7.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.03
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC ARWY NASAL 14FR THIN WALL STERILE
|
Facility
|
IP
|
$15.33
|
|
| Hospital Charge Code |
901606461
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
|
|
HC ARWY NASAL 16FR THIN WALL STERILE
|
Facility
|
IP
|
$15.33
|
|
| Hospital Charge Code |
901606462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
|
|
HC ARWY NASAL 16FR THIN WALL STERILE
|
Facility
|
OP
|
$15.33
|
|
| Hospital Charge Code |
901606462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.92
|
| Rate for Payer: Blue Shield of California Commercial |
$9.72
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: Cigna of CA HMO |
$9.81
|
| Rate for Payer: Cigna of CA PPO |
$11.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
| Rate for Payer: Riverside University Health System MISP |
$6.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.67
|
| Rate for Payer: United Healthcare All Other HMO |
$7.67
|
| Rate for Payer: United Healthcare HMO Rider |
$7.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.03
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC ARWY NASAL 18FR ADJ FLNGE SFT
|
Facility
|
IP
|
$37.31
|
|
| Hospital Charge Code |
901698391
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$33.58 |
| Rate for Payer: Adventist Health Commercial |
$7.46
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Central Health Plan Commercial |
$29.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.92
|
| Rate for Payer: EPIC Health Plan Senior |
$14.92
|
| Rate for Payer: Galaxy Health WC |
$31.71
|
| Rate for Payer: Global Benefits Group Commercial |
$22.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.46
|
| Rate for Payer: Multiplan Commercial |
$27.98
|
| Rate for Payer: Networks By Design Commercial |
$24.25
|
| Rate for Payer: Prime Health Services Commercial |
$31.71
|
|
|
HC ARWY NASAL 18FR ADJ FLNGE SFT
|
Facility
|
OP
|
$37.31
|
|
| Hospital Charge Code |
901698391
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$33.58 |
| Rate for Payer: Adventist Health Commercial |
$7.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.70
|
| Rate for Payer: Blue Shield of California Commercial |
$23.65
|
| Rate for Payer: Blue Shield of California EPN |
$14.89
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Central Health Plan Commercial |
$29.85
|
| Rate for Payer: Cigna of CA HMO |
$23.88
|
| Rate for Payer: Cigna of CA PPO |
$27.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.92
|
| Rate for Payer: EPIC Health Plan Senior |
$14.92
|
| Rate for Payer: Galaxy Health WC |
$31.71
|
| Rate for Payer: Global Benefits Group Commercial |
$22.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.12
|
| Rate for Payer: Multiplan Commercial |
$27.98
|
| Rate for Payer: Networks By Design Commercial |
$24.25
|
| Rate for Payer: Prime Health Services Commercial |
$31.71
|
| Rate for Payer: Riverside University Health System MISP |
$14.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.66
|
| Rate for Payer: United Healthcare All Other HMO |
$18.66
|
| Rate for Payer: United Healthcare HMO Rider |
$18.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.71
|
| Rate for Payer: Vantage Medical Group Senior |
$31.71
|
|
|
HC ARWY NASAL 18FR THIN WALL STERILE
|
Facility
|
OP
|
$15.33
|
|
| Hospital Charge Code |
901606463
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.92
|
| Rate for Payer: Blue Shield of California Commercial |
$9.72
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: Cigna of CA HMO |
$9.81
|
| Rate for Payer: Cigna of CA PPO |
$11.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
| Rate for Payer: Riverside University Health System MISP |
$6.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.67
|
| Rate for Payer: United Healthcare All Other HMO |
$7.67
|
| Rate for Payer: United Healthcare HMO Rider |
$7.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.03
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC ARWY NASAL 18FR THIN WALL STERILE
|
Facility
|
IP
|
$15.33
|
|
| Hospital Charge Code |
901606463
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
|
|
HC ARWY NASAL 20FR THIN WALL STERILE
|
Facility
|
IP
|
$13.94
|
|
| Hospital Charge Code |
901606464
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$12.55 |
| Rate for Payer: Adventist Health Commercial |
$2.79
|
| Rate for Payer: Cash Price |
$6.27
|
| Rate for Payer: Central Health Plan Commercial |
$11.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Senior |
$5.58
|
| Rate for Payer: Galaxy Health WC |
$11.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.79
|
| Rate for Payer: Multiplan Commercial |
$10.46
|
| Rate for Payer: Networks By Design Commercial |
$9.06
|
| Rate for Payer: Prime Health Services Commercial |
$11.85
|
|
|
HC ARWY NASAL 20FR THIN WALL STERILE
|
Facility
|
OP
|
$13.94
|
|
| Hospital Charge Code |
901606464
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$12.55 |
| Rate for Payer: Adventist Health Commercial |
$2.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.11
|
| Rate for Payer: Blue Shield of California Commercial |
$8.84
|
| Rate for Payer: Blue Shield of California EPN |
$5.56
|
| Rate for Payer: Cash Price |
$6.27
|
| Rate for Payer: Central Health Plan Commercial |
$11.15
|
| Rate for Payer: Cigna of CA HMO |
$8.92
|
| Rate for Payer: Cigna of CA PPO |
$10.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Senior |
$5.58
|
| Rate for Payer: Galaxy Health WC |
$11.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.76
|
| Rate for Payer: Multiplan Commercial |
$10.46
|
| Rate for Payer: Networks By Design Commercial |
$9.06
|
| Rate for Payer: Prime Health Services Commercial |
$11.85
|
| Rate for Payer: Riverside University Health System MISP |
$5.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.97
|
| Rate for Payer: United Healthcare All Other HMO |
$6.97
|
| Rate for Payer: United Healthcare HMO Rider |
$6.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.85
|
| Rate for Payer: Vantage Medical Group Senior |
$11.85
|
|
|
HC ARWY NASAL 26FR STERILE
|
Facility
|
IP
|
$14.68
|
|
| Hospital Charge Code |
901606465
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Cash Price |
$6.61
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
|
|
HC ARWY NASAL 26FR STERILE
|
Facility
|
OP
|
$14.68
|
|
| Hospital Charge Code |
901606465
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.54
|
| Rate for Payer: Blue Shield of California Commercial |
$9.31
|
| Rate for Payer: Blue Shield of California EPN |
$5.86
|
| Rate for Payer: Cash Price |
$6.61
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: Cigna of CA HMO |
$9.40
|
| Rate for Payer: Cigna of CA PPO |
$10.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.28
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
| Rate for Payer: Riverside University Health System MISP |
$5.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.34
|
| Rate for Payer: United Healthcare All Other HMO |
$7.34
|
| Rate for Payer: United Healthcare HMO Rider |
$7.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.48
|
| Rate for Payer: Vantage Medical Group Senior |
$12.48
|
|
|
HC ARWY NASAL 28FR STERILE
|
Facility
|
OP
|
$14.68
|
|
| Hospital Charge Code |
901606466
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.54
|
| Rate for Payer: Blue Shield of California Commercial |
$9.31
|
| Rate for Payer: Blue Shield of California EPN |
$5.86
|
| Rate for Payer: Cash Price |
$6.61
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: Cigna of CA HMO |
$9.40
|
| Rate for Payer: Cigna of CA PPO |
$10.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.28
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
| Rate for Payer: Riverside University Health System MISP |
$5.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.34
|
| Rate for Payer: United Healthcare All Other HMO |
$7.34
|
| Rate for Payer: United Healthcare HMO Rider |
$7.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.48
|
| Rate for Payer: Vantage Medical Group Senior |
$12.48
|
|
|
HC ARWY NASAL 28FR STERILE
|
Facility
|
IP
|
$14.68
|
|
| Hospital Charge Code |
901606466
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Cash Price |
$6.61
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
|
|
HC ARWY NASAL 30FR SOFT LF
|
Facility
|
IP
|
$86.34
|
|
| Hospital Charge Code |
901698476
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$77.71 |
| Rate for Payer: Adventist Health Commercial |
$17.27
|
| Rate for Payer: Cash Price |
$38.85
|
| Rate for Payer: Central Health Plan Commercial |
$69.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.54
|
| Rate for Payer: EPIC Health Plan Senior |
$34.54
|
| Rate for Payer: Galaxy Health WC |
$73.39
|
| Rate for Payer: Global Benefits Group Commercial |
$51.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$77.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$54.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.27
|
| Rate for Payer: Multiplan Commercial |
$64.75
|
| Rate for Payer: Networks By Design Commercial |
$56.12
|
| Rate for Payer: Prime Health Services Commercial |
$73.39
|
|
|
HC ARWY NASAL 30FR SOFT LF
|
Facility
|
OP
|
$86.34
|
|
| Hospital Charge Code |
901698476
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$77.71 |
| Rate for Payer: Adventist Health Commercial |
$17.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$52.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$41.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.22
|
| Rate for Payer: Blue Shield of California Commercial |
$54.74
|
| Rate for Payer: Blue Shield of California EPN |
$34.45
|
| Rate for Payer: Cash Price |
$38.85
|
| Rate for Payer: Central Health Plan Commercial |
$69.07
|
| Rate for Payer: Cigna of CA HMO |
$55.26
|
| Rate for Payer: Cigna of CA PPO |
$63.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$73.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.54
|
| Rate for Payer: EPIC Health Plan Senior |
$34.54
|
| Rate for Payer: Galaxy Health WC |
$73.39
|
| Rate for Payer: Global Benefits Group Commercial |
$51.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$77.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$54.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$60.44
|
| Rate for Payer: Multiplan Commercial |
$64.75
|
| Rate for Payer: Networks By Design Commercial |
$56.12
|
| Rate for Payer: Prime Health Services Commercial |
$73.39
|
| Rate for Payer: Riverside University Health System MISP |
$34.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.17
|
| Rate for Payer: United Healthcare All Other HMO |
$43.17
|
| Rate for Payer: United Healthcare HMO Rider |
$43.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.39
|
| Rate for Payer: Vantage Medical Group Senior |
$73.39
|
|
|
HC ARWY NASAL 30FR SOFT PVC
|
Facility
|
IP
|
$37.23
|
|
| Hospital Charge Code |
901698475
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.45 |
| Max. Negotiated Rate |
$33.51 |
| Rate for Payer: Adventist Health Commercial |
$7.45
|
| Rate for Payer: Cash Price |
$16.75
|
| Rate for Payer: Central Health Plan Commercial |
$29.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.89
|
| Rate for Payer: EPIC Health Plan Senior |
$14.89
|
| Rate for Payer: Galaxy Health WC |
$31.65
|
| Rate for Payer: Global Benefits Group Commercial |
$22.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.45
|
| Rate for Payer: Multiplan Commercial |
$27.92
|
| Rate for Payer: Networks By Design Commercial |
$24.20
|
| Rate for Payer: Prime Health Services Commercial |
$31.65
|
|
|
HC ARWY NASAL 30FR SOFT PVC
|
Facility
|
OP
|
$37.23
|
|
| Hospital Charge Code |
901698475
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.45 |
| Max. Negotiated Rate |
$33.51 |
| Rate for Payer: Adventist Health Commercial |
$7.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.66
|
| Rate for Payer: Blue Shield of California Commercial |
$23.60
|
| Rate for Payer: Blue Shield of California EPN |
$14.85
|
| Rate for Payer: Cash Price |
$16.75
|
| Rate for Payer: Central Health Plan Commercial |
$29.78
|
| Rate for Payer: Cigna of CA HMO |
$23.83
|
| Rate for Payer: Cigna of CA PPO |
$27.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.89
|
| Rate for Payer: EPIC Health Plan Senior |
$14.89
|
| Rate for Payer: Galaxy Health WC |
$31.65
|
| Rate for Payer: Global Benefits Group Commercial |
$22.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.06
|
| Rate for Payer: Multiplan Commercial |
$27.92
|
| Rate for Payer: Networks By Design Commercial |
$24.20
|
| Rate for Payer: Prime Health Services Commercial |
$31.65
|
| Rate for Payer: Riverside University Health System MISP |
$14.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.61
|
| Rate for Payer: United Healthcare All Other HMO |
$18.61
|
| Rate for Payer: United Healthcare HMO Rider |
$18.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.65
|
| Rate for Payer: Vantage Medical Group Senior |
$31.65
|
|
|
HC ARWY NASAL 30FR SOFT STRL
|
Facility
|
OP
|
$37.31
|
|
| Hospital Charge Code |
901698477
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$33.58 |
| Rate for Payer: Adventist Health Commercial |
$7.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.70
|
| Rate for Payer: Blue Shield of California Commercial |
$23.65
|
| Rate for Payer: Blue Shield of California EPN |
$14.89
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Central Health Plan Commercial |
$29.85
|
| Rate for Payer: Cigna of CA HMO |
$23.88
|
| Rate for Payer: Cigna of CA PPO |
$27.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.92
|
| Rate for Payer: EPIC Health Plan Senior |
$14.92
|
| Rate for Payer: Galaxy Health WC |
$31.71
|
| Rate for Payer: Global Benefits Group Commercial |
$22.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.12
|
| Rate for Payer: Multiplan Commercial |
$27.98
|
| Rate for Payer: Networks By Design Commercial |
$24.25
|
| Rate for Payer: Prime Health Services Commercial |
$31.71
|
| Rate for Payer: Riverside University Health System MISP |
$14.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.66
|
| Rate for Payer: United Healthcare All Other HMO |
$18.66
|
| Rate for Payer: United Healthcare HMO Rider |
$18.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.71
|
| Rate for Payer: Vantage Medical Group Senior |
$31.71
|
|
|
HC ARWY NASAL 30FR SOFT STRL
|
Facility
|
IP
|
$37.31
|
|
| Hospital Charge Code |
901698477
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$33.58 |
| Rate for Payer: Adventist Health Commercial |
$7.46
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Central Health Plan Commercial |
$29.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.92
|
| Rate for Payer: EPIC Health Plan Senior |
$14.92
|
| Rate for Payer: Galaxy Health WC |
$31.71
|
| Rate for Payer: Global Benefits Group Commercial |
$22.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.46
|
| Rate for Payer: Multiplan Commercial |
$27.98
|
| Rate for Payer: Networks By Design Commercial |
$24.25
|
| Rate for Payer: Prime Health Services Commercial |
$31.71
|
|
|
HC ARWY NASAL 30FR STERILE
|
Facility
|
IP
|
$14.68
|
|
| Hospital Charge Code |
901606467
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Cash Price |
$6.61
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
|
